NPI | 1356549265 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053009) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT001921E) |
Enumeration Date | 2007-07-03 |
Last Update Date | 2020-12-16 |